Summary
Definition
History and exam
Key diagnostic factors
- fever
- pharyngitis
- cervical or generalized lymphadenopathy
- malaise
Other diagnostic factors
- splenomegaly
- rash
- signs of hepatitis (hepatomegaly, jaundice)
- jaundice
- myalgia
Risk factors
- kissing
- sexual behavior
Diagnostic tests
1st tests to order
- CBC
- heterophile antibodies
- Epstein-Barr virus (EBV)-specific antibodies
- LFTs
Tests to consider
- real-time polymerase chain reaction (PCR)
- ultrasonography of abdomen
- CT of abdomen
Treatment algorithm
all patients
Contributors
Authors
George Turabelidze, MD, PhD
Medical Epidemiologist
Missouri Department of Health and Senior Services
Adjunct Assistant Professor of Clinical Pediatrics
Washington University School of Medicine
St Louis
MO
Disclosures
GT declares that he has no competing interests.
Peer reviewers
Linda Kalilani, MBBS, MPhil, PhD
Epidemiologist
College of Medicine
University of Malawi
Zomba
Malawi
Disclosures
LK declares that she has no competing interests.
Paul G. Auwaerter, MD, MBA, FACP, FIDSA
Clinical Director
Division of Infectious Diseases
Associate Professor of Medicine
Divisions of Infectious Diseases and General Internal Medicine
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
PGA declares that he has no competing interests.
Differentials
- Group A streptococcal pharyngitis
- Hepatitis A
- Acute HIV infection
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